CHAD J JOHNSON (DO) – Sports Medicine (Family Medicine) Physician, NPI 1871881052

CHAD J JOHNSON (DO) is a healthcare provider. based in Boise, Idaho. specializing in SPORTS MEDICINE, FAMILY PRACTICE. They hold the professional credentials DO. They hold a License No. 8974078-1204 (UT). The NPI Number for CHAD J JOHNSON (DO) is 1871881052

Main info

Male
Sole Proprietor
15 Years Of Experience
Accepts Medicare Assignment
Name
CHAD J JOHNSON (DO)
NPI
1871881052
Phone
(208) 706-8526
Address
190 E BANNOCK ST
Enumeration Date
21 July 2011
Last Update Date
23 September 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2087358585
Graduation Year
2011 (15 years ago)
PAC ID
6608021159
Group Practice PAC ID
4587102470
Professional Enrollment ID
I20150825003434
Address ID
ID833013467TW1411XEXXX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience71
Completeness75
Years active:14State licenses:2Digital endpointsOther names

51 SPORTS MEDICINE in ID

Provider Addresses for CHAD J JOHNSON (DO)

  • 190 E BANNOCK ST

    BOISE, ID 837126241

    Phone: (208) 706-8526

    Type: Mailing

  • 738 N. COLLEGE RD.

    SUITE A

    TWIN FALLS, ID 83301

    Phone: (208) 814-5075

    Fax: (208) 814-5074

    Type: Location

  • 1411 FALLS AVE E STE 1301

    TWIN FALLS, ID 833013467

    Phone: (208) 735-8585

    Fax: (208) 933-2001

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 9 Open Payments records for all available years, with a total value of $271.

Total Amount is formed as General ($271) + Research ($0) + Ownership ($0) = $271.

Last reported payment date: 2024-12-20 • Largest payer in this snapshot: Sonex Health, Inc. ($106).

Total Amount

$271

General + Research + Ownership

Payments

9

Total payment records

General Amount

$271

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-20

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2015-08-25

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20150825003434ISports MedicineIDTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
20611Aspiration and/or injection of fluid large joint using ultrasound guidance351186$0
20610Aspiration and/or injection of fluid from large joint9444$0
99213Established patient office or other outpatient visit, 20-29 minutes4637$0
20604Aspiration and/or injection of fluid from small joint using ultrasound guidance4627$0
99214Established patient office or other outpatient visit, 30-39 minutes4337$0
View full utilization report →

Insurance plans in this area (ZIP 83712)

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Provider's Procedures

CHAD J JOHNSON (DO) performs procedures in SPORTS MEDICINE. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
SPORTS MEDICINEID20610Aspiration and/or injection of large joint or joint capsule7448

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4587102470View full group profile
NameSpecialtyState
Nurse PractitionerID

Reviews

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Frequently asked questions

Does CHAD J JOHNSON (DO) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — CHAD J JOHNSON (DO) uses 1871881052.
Is CHAD J JOHNSON (DO) still practicing?
CHAD J JOHNSON (DO) is currently listed as active in the public NPI registry.
What is CHAD J JOHNSON (DO)'s primary classification?
Sports Medicine (Family Medicine) Physician is the headline specialty for CHAD J JOHNSON (DO) here. Clinical services aligned with this taxonomy classification.
What address line appears for CHAD J JOHNSON (DO)?
CHAD J JOHNSON (DO)'s geographic hint is Boise, Idaho in our summary view.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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